Amanda Preisinger experiences worry about her daughter’s upcoming 13th birthday party. It’s not due to the typical causes related to a home packed of clamorous adolescent kids, but because it’s the first time she will debut her new face to friends and extended family. “Clearly I’m going to inform everyone as they arrive, ‘For your information, this is not how I look,’” says the thirty-year-old property agent from Southern Florida.
Her appearance is, well, a somewhat surprising – her face puffed up and preternaturally lifted, as though secured by industrial-grade tape. Her new – and she’s keen to stress, temporary – appearance is the outcome of six cosmetic procedures, such as an endoscopic mid-facelift, performed by a doctor in Turkey’s Istanbul, the previous month. “My poor husband became emotional when he saw me for the first time because I wasn’t able to even open my eyes. That’s how swollen I was,” she explains to me via video call from her home. “I needed to inform him: ‘Honey, I’m okay, I’m not in pain. I just look like someone jumped me.’”
Based on plastic surgeons, Preisinger is among a rising count of individuals choosing to undergo a facelift in their 20s and 30s – significantly before a ten years prior to typical surgeons’ usual candidate age of forty to sixty. (Although many specialists are keen to emphasise the industry edict of: “We treat genetics, not age.”) “I have 28-year-olds requesting facelifts,” states based in London cosmetic surgeon Georgios Orfaniotis, a ex-NHS doctor who specialises in the facial area. “It’s a major surgery, and I’m a bit concerned when I observe individuals choosing it as a personal preference.”
A rhytidectomy, alternatively called a rhytidectomy, elevates the tissues in the face that start to sag as we age. “Human faces are structured a little like onion layers,” says Kent-based face specialist Marc Pacifico. “Skin and fat on the top, then a layer of supportive tissue called the superficial musculoaponeurotic system. Think of the SMAS as the soft tissue skeleton of the face. And that’s what causes aging; that’s what becomes lax and drags the dermis downward with it.”
You risk performing surgery on people that have underlying problems. It’s not advisable for an ethical plastic surgeon to follow
Previously reserved of moneyed older people, overuse of injectables – when excessive use of dermal fillers expands the face and causes laxity in the dermis – combined with the widespread use of slimming medications, cut-price surgical travel, and the advancement of novel, famous-figure-promoted surgical techniques are driving a new kind of patient towards this major operation. Statistics show an 8% increase in facial lifts over the last year in the United Kingdom; while a survey revealed that the portion of youthful candidates is growing, with one-third of procedures now performed on patients aged 35-55.
“Patients are asking now to appear as the optimal form of themselves and naturally the methods are following,” says Orfaniotis. At present, the trending procedure is the deep plane facelift, a method evangelised by figures including reality TV star Kris Jenner, to fashion designer Marc Jacobs.
Where a more traditional rhytidectomy entails lifting the SMAS, the deep plane facelift loosens the facial ligaments underneath, allowing doctors to restructure the face by repositioning the underlying layers, and preventing the taut, pulled look sometimes wrought by older methods. “We’re not putting tension on the skin because we’re going below, to the deeper tissue,” explains prestigious London plastic surgeon Rajiv Grover, who focuses on the advanced method. “It is the underlying layers that is repositioned. The dermis comes with it as a secondary element.” Lifting the whole facial structure as a unified block results in a more natural-looking and longer-lasting outcome. It also means that the procedure is not just being used for the primary goal of anti-ageing – or rejuvenation, as the cosmetic field terms it – but for “beautification” and contouring, too. “We receive numerous requests from patients aged 28 to 35 for this purpose,” says Grover.
Preisinger had not intended on undergoing a facelift – at minimum not at the thirty years old. But years of using hyaluronic acid dermal fillers in an effort at “symmetry correction” implied that by the time she entered her late twenties, she was “damaged”. “I didn’t undergo this because I desired to appear young,” she says. “I underwent it because the injectable ruined my face. I regret ever using it. If I didn’t have the injectable, I don’t think I would be where I’m at currently.”
If dermal fillers ever fully dissolve has long been a point of contention in the cosmetic field. “Studies have indicated that they seldom fully dissipate,” states Grover, “but they migrate and can obstruct drainage pathways. One of the contributors to what we call ‘pillow face’ is also the fact that to some extent, the face gets slightly fluid-filled because its ability to drain lymphatic fluid has been diminished.” Although studies into the area is preliminary, warnings on injectables’ potential impact on the lymphatic system have been issued, and further research announced. One highly regarded facial plastic surgeon, speaking anonymously, says he would avoid using injectables in a patient because of the risks they pose. “Many surgeons avoid talk about this, because the manufacturers who make injectables can be quite forceful.” He’s heard stories, he says, of plastic surgeons being landed with legal actions after expressing worries.
For Preisinger, once she started using injectables, she felt as if she had to keep adding more – particularly when it began moving to other parts of her face. She was just 28 when a nearby cosmetic doctor in Florida suggested that a face and neck lift might be what she needed to exit the injectable hamster wheel. After 24 months, she ended up selecting from a selection of suggested accommodations in Istanbul, texted to her by the clinic assistant at her doctor’s clinic.
Originally, Preisinger had planned for an upper and lower blepharoplasty – better known as eyelid surgery – but her surgeon recommended that a facelift was the correct option for the looseness she was experiencing in her face. She booked a forehead lift, a cheek lift and a jawline surgery. The day before her surgery, 24 hours post she’d touched down alone in the country, she opted to include a mouth enhancement. “Then he said, ‘We’re going to elevate the under-eye bags.’ Then he said, ‘I believe if we remove some buccal fat, it will sculpt your face.’ Thus I ultimately adding two more surgeries,” she says. She spent $22,000 (sixteen thousand five hundred pounds) for the half-day surgery, including a three-day|
Elena Vance is a digital strategist and creative director with over a decade of experience in transforming brands through innovative design.